Validation of sleep observations in a nursing home.

Most of the studies on sleep patterns in elderly people have been performed on small samples in sleep laboratories and with the use of advanced technology. Such technology is generally unavailable either for research studies or clinical interventions with elderly people residing in the community. Additionally, the utility of the sleep laboratory in assessing sleep in the very demented patient is limited because of irregularities of electroencephalogram (EEG) patterns in this population. For these reasons, systematic sleep observations are presented as important tools in the assessment of sleep in the nursing home. Nursing homes have night-shift staff who are frequently not fully occupied and could be trained to perform sleep observations. The Observational Sleep Assessment Instrument (OSAI) documents the occurrence of sleep, as well as disruptions in sleep, breathing, snoring, myoclonic movements, and body restlessness. This study documented the validity of the OSAI by establishing interrater reliability and by correlating its results to those of a portable sleep monitor, namely, a four-channel ambulatory sleep respiratory monitor and a wrist activity monitor. Results show that the OSAI is a reliable and valid tool for examining sleep and sleep pathology in this population, and can become a useful screening tool for detecting sleep and breathing disorders.